Clinical Pharmacology & Biopharmaceutics
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Regular medication review is recommended for elderly patients and those on multiple drug therapy. The overall objective of
such reviews is to ensure that drugs are prescribed and used appropriately and that patients are deriving maximum benefit
from their drug regimes. As such, medication review requires knowledge of a patient's medical problems that are treatable with
medicines, the medicines that are prescribed for those problems, and an appreciation of the patient's level of understanding and
adherence with that medicine. It is increasingly recognised that pharmacists should be involved in the process of medication review
if the patient is to receive optimal pharmaceutical care. There are numerous examples of clinical scenarios in which pharmacist-led
medication review has improved patient adherence patterns and clinical outcomes.
Overall, it appears that the professional expertise of pharmacists in conducting medication reviews can be demonstrated
most clearly in discrete disease areas/clinical scenarios. Well-designed, randomized studies in which outcome measures are rather
narrowly defined (eg blood pressure or blood sugar indices) appear to be more likely to indicate positive benefits of medication
review, whereas generalised outcomes such as mortality, morbidity and quality of life appear more resistant to such interventions.
This has provoked serious debate in the literature, much of which pits the professions of pharmacy and medicine against each
other. Here, evidence for the benefit of medication reviews by pharmacists is reviewed and discussed with the aim of identifying
confounding factors that are currently hindering progress in this important area of pharmacy practice.
Helen C. Gallagher B.Sc. (Hons), B. Pharm., M.Pharm., Ph.D., MPSI, holds degrees in Pharmacology and Pharmacy from University College
Dublin, Trinity College Dublin & The Royal College of Surgeons in Ireland. She is a Lecturer in the School of Medicine and Medical Science,
University College Dublin, Ireland, and works part-time as a Community Pharmacist. Her main research interests are in the areas of anaesthetics/
pain medicine, neuropharmacology & pharmaceutical care. She is currently the recipient of a Cochrane Fellowship from the Health Research Board
of Ireland and a member of the Cochrane Pain, Palliative & Supportive Care Review Group.
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